Table 4.
Published Clinical Studies on Exploiting Exosomes as Diagnostic, Prognostic, or Predictive Biomarkers in Various Types of Cancer
| Biomarker Function | Exosomes/Exosomal Cargo Content | Specimen Origin | Cancer Type | Utilization | References (First Author, Year) |
|---|---|---|---|---|---|
| DIAGNOSTIC | |||||
| Exosomal lncRNAs | Cervicovaginal lavage | Uterine cervix | Differentiate cervical cancer from normal controls | Zhang J, 2016103 | |
| ExomiR-1246 | Serum | Breast | 100% sensitivity and 92.9% specificity | Zhai LY, 201861 | |
| miRNAs from the miR-106a-363 cluster | Plasma and serum | Breast | Serve as potential diagnostic biomarkers | Li M, 2018102 | |
| Exosomal phosphatidylserine | Serum | Ovary | AUC of 1.0 for predicting malignant against normal | Lea J, 2017104 | |
| Urinary 3-gene expression assay | Urine | Men with elevated PSA levels | Discriminate between Gleason score (GS)7 and GS6 prostate cancer and benign disease on initial biopsy | McKiernan J, 2016;100 McKiernan J, 2018105 | |
| Exosomal shuttle RNA pattern | Urine | Clear cell renal cell carcinoma | Provide a noninvasive test to diagnose clear cell RCC | De Palma G, 2016106 | |
| Exosomal miR-25-3p | Serum | Osteosarcoma | Reflect tumor burden | Fujiwara T, 2017;82 Yoshida A, 2018107 | |
| Exosomal lncRNA PRINS | Serum | Multiple myeloma or monoclonal gammopathies | Differentiate from healthy donors: sensitivity 84.9% and specificity 83.3% | Sedlarikova L, 2018108 | |
| Tumor-derived exosomal miRNAs | Plasma | Early-stage NSCLC | Differentiate adenocarcinoma from squamous cell carcinoma | Jin X, 2017109 | |
| Exosomal microRNA-191, - 21, −451a | Serum | Pancreas | Differentiate cancer and IPMN from normal | Goto T, 201872 | |
| Exosomal RNA cargo | Serum | Pancreas | Differentiate cancer from healthy controls in blinded studies | Ko J, 201727 | |
| Exosomal miRNA-21 and miRNA-181a-5p | Serum | Thyroid | Differentiate follicular from papillary thyroid cancer | Samsonov R, 2016101 | |
| Phosphatidylserine-expressing CDEs | Blood of tumor-bearing mice | Early-stage malignancies | Detect very early-stage cancers before clinical evidence of disease in four mouse models. | Sharma R, 2017110 | |
| PROGNOSTIC | |||||
| Exosomal miR-21 | Serum | Pediatric hepatoblastoma | Predict event-free survival | Liu W, 201675 | |
| Exosomal cancer stem cell-like marker CD133 | Ascites | Pancreas | Western blot revealed enhanced expression of CD133 in exosomes from pancreatic cancer patients | Sakaue, T. 2019111 | |
| Exosomal miR-638 | Serum | Hepatocellular carcinoma | Lower levels of serum exosomal miR-638 associates with poor overall survival | Shi M, 2018112 | |
| PREDICTIVE | |||||
| Chimeric GOLM1-NAA35 RNA | Saliva | Esophageal squamous cell carcinoma | Changes in chimeric RNA levels predict PFS after chemoradiation. | Lin Y 2019113 | |
| Exosomal EpCAM protein | Plasma | Pancreas (on palliative chemotherapy) | Exosomal EpCAM increase during treatment was associated with better PFS | Giampieri, R. 201988 | |
| Exosomal glutathione S-transferase P1 | Serum | Breast (on neoadjuvant anthracycline/taxane) | GSTP1 from the PD/SD group was significantly higher than those in the PR/CR group | Yang SJ 201799 | |
Abbreviations: AUC, area under the curve; ExomiR, exosomal microRNA; lncRNAs, long noncoding RNAs; IPMN, intraductal papillary mucinous neoplasm; NSCLC, non-small cell lung cancer; PSA, prostate-specific antigen; PFS, progression-free survival.